Efficiency of intraoperative frozen section analysis of central neck lymph node dissection in patients with papillary thyroid carcinoma

M. J. Kim, C. Kim, Je Kim, Young Sam Park
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引用次数: 4

Abstract

Background and Objective: Because of the high survival rate and low recurrence rate of thyroid carcinoma, the therapeutic process is changing from aggressive treatment to submissive treatment. Currently, choosing central node dissection (CND) as a treatment option is considered controversial since. This approach has been shown to have poor outcomes. Therefore, we conducted this study to confirm whether the intraoperative frozen section analysis (IFSA) of CND during surgery affects treatment outcomes of patients with this type of cancer. Materials and Methods: First, we collected the medical records of 265 patients who underwent surgery for papillary thyroid cancer at the Presbyterian Medical Center from 2014 to 2016. The patients were divided into 2 groups: IFSA and non-IFSA. The outcomes of treatment options were then assessed. We analyzed the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of IFSA of CND. Results: Of the 265 patients in the study, 74 patients (89%) in the IFSA group and 95 patients (52.2%) in the non-IFSA group were treated appropriately (P-value=0.000). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of IFSA of CND were 93.5%, 100%, 100%, 96.3%, and 97.5%, respectively. Conclusions: The IFSA of CND is a useful method to confirm central node metastasis during surgery. Determining the range of surgery required for each patient using this method is useful for ensuring minimal complications and for providing a successful, effective oncologic surgery.
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甲状腺乳头状癌中颈中央淋巴结清扫术中冰冻切片的疗效分析
背景与目的:由于甲状腺癌的高生存率和低复发率,治疗过程正从积极治疗向顺从治疗转变。目前,选择中央淋巴结清扫(CND)作为治疗方案被认为是有争议的。事实证明,这种方法的效果很差。因此,我们进行了这项研究,以确认术中CND的术中冷冻切片分析(IFSA)是否会影响这类癌症患者的治疗结果。材料与方法:首先,我们收集了2014 - 2016年长老会医疗中心265例甲状腺乳头状癌手术患者的医疗记录。将患者分为IFSA组和非IFSA组。然后评估治疗方案的结果。分析IFSA诊断CND的敏感性、特异性、阳性预测值、阴性预测值及准确性。结果:265例患者中,IFSA组74例(89%),非IFSA组95例(52.2%)得到适当治疗(p值=0.000)。IFSA诊断CND的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为93.5%、100%、100%、96.3%和97.5%。结论:颈椎病的IFSA是诊断手术中中心淋巴结转移的有效方法。使用这种方法确定每位患者所需的手术范围有助于确保并发症最小化,并提供成功、有效的肿瘤手术。
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